Abstract
There is limited research on how different treatment modalities relate to holistic recovery outcomes for alcohol or other drug-related use disorders among college students. Using national data from the American College Health Association-National College Health Assessment III (2019–2022), we analyzed 1,816 students who reported an alcohol or other drug-related use disorder, had engaged with a healthcare or mental health professional in the past year, and indicated a treatment type received. Multivariate linear regression examined associations between treatment modalities, including no treatment, medication only, therapy only, combined therapy and medication, Alcoholics Anonymous (AA), Narcotics Anonymous (NA), 12-Step programs, and other treatments, and the Substance Abuse and Mental Health Services Administration’s four recovery domains of health, home, purpose, and community. Students participating in AA/NA/12-Step programs demonstrated the highest mean scores across all domains, whereas those receiving no treatment had the lowest. In adjusted models, engagement in AA/NA/12-Step programs or combined therapy and medication was associated with significantly higher overall recovery scores compared with no treatment or single-modality approaches. These findings emphasize the role of social support and integrated treatment in fostering recovery and inform the design of individualized university recovery programs. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1038/s41598-026-43756-6.